An exploration into the health industry with particular focus on the men and women battling and saving lives in our ERs.

3/23/11

A nurse submitted article, part two of a two part series that started here....

.....I went back to my alcove to start charting around 2100. I felt good about that at least. I had already assessed both of my patients and had given nighttime medications. Did I mention this was my 3rd shift on the floor as a new travel nurse, and my 1st shift on my own? The charting system was new to me, so I was glad I had a chunk of time to devote to navigating the charting system.

As I was in the midst of checking boxes and tabbing along, the alarm went off for my patient’s arterial line for a low reading. I looked at the tracing and wondered why it had dampened, when it was brand new that day. My patient still had an EKG tracing, but I went in to check on her to make sure she was okay.

I should also note that my patient was in droplet isolation. I gowned up, put on my gloves and mask and started in to see that my patient was not the responsive, bright eyed, smiling patient that I had come into that shift. I tried to rouse her several times, and then proceeded to check a pulse and did not find one. I called out to call a Code Blue. She had pulseless electrical activity (PEA), which progressed to asystole. I started compressions almost immediately, her frail body surrendering to beneath me. Must. Pump. Hard. It’s an indescribable sensation to feel someone’s ribs moving under your hands, as you try to do the work the heart cannot do itself.

My coworkers ran to assist me, the Code team arrived, someone else took over compressions, someone else gave ACLS medications, and there I was watching (and also providing what I could remember about the patient’s condition and history).

They let her go with just enough effort and called the code at 2133, which was about 15 minutes after I discovered the change. Coming from an open-heart surgery background, I was astonished by the short duration of the code, but also felt at peacewith it. I’ve watched a code go on for over an hour, thinking, when are we just going to give up? There are only so many medications you can give before the body rebels. I’m sure many of you have had this same thought, just know you are not alone.

What I’ve taken away from this experience:

That it can happen to anyone, anywhere.That nurses are great team players when there is a code.That my nursing skills transmit to a variety of environments.And that my gut is never wrong.

If you get the feeling that something is not quite right with your patient, but you can’t put your finger on it, you’re probably right......